Hand Surgery

Renowned consultant for complex hand and wrist surgery at leading London teaching hospital, Guys and St Thomas'. Matthew James is Program director of the advanced hand surgery course.

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A typical hand surgery operation is performed as a day-case under a regional anaesthetic (injected in the armpit or above the shoulder, to numb the entire arm); the patient is awake or lightly sedated, according to preference. General anaesthesiaand/or overnight stay in hospital are unusual but are required for some operations on the hand, such as in children or when surgery is prolonged.The majority of hand surgery can be performed under a local anaesthetic. Are use a tourniquet assisted technique for rapid pain-free and bloodless exploration of injured tissue that may require reconstruction by the surgeon. This allows direct visualisation of movement of important tissues such as tendon and ligament.

The operation is described as a tourniquet assisted local anaesthetic technique with no tumescence hence talent.The majority of surgery is performed in a minor operation theatre with a minimum of fuss I remove all sutures from my patients at 10 days following surgery and commenced rehabilitation a few days after surgery.

Occasionally patients may require extra rehabilitation following the injury with the assistance of Hand Therapy‘s. It is important to maintain nutrition and good state of mind in the injury phase. Encourage patients to move the hand in the early phases to encourage neuro integration. And should be rested and elevated  to avoid swelling and encourage movement. Following hand injury stiffness can cause problems and the aim of rehabilitation is to speed recovery to return of daily activities of living.Here I demonstrate a case of a tendon injury which was repaired under local anaesthetic and a tendon reconstruction  for a gentleman with an unstable joint following a fall from a bicycle.


Breast Lift

Day Case


Day Case

Nerve Repair Surgery

Day Case